阻塞性睡眠呼吸暂停低通气综合征患者尿微量白蛋白变化及其相关因素分析

The changes of urinary microalbumin and its correlative factors in patients with obstructive sleep apnea hypopnea syndrome

目的探讨尿微量白蛋白（UMA）用于监测阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者早期肾损害的临床意义。方法对照组82例，OSAHS组67例。测量比较两组研究对象的各身体参数和SCr、BUN、肾小球滤过率（GFR）、UMA。并将OSAHS组UMA分别与各身体参数、SCr、BUN、GFR及睡眠呼吸检测指标进行直线相关分析。结果OSAHS组患者腰围、颈围、体重指数（BMI）及UMA与对照组比较差异有统计学意义（P〈0．01），OSAHS患者UMA与BMI、睡眠呼吸暂停低通气指数、SaO2〈90％占总睡眠时间百分比、睡眠呼吸障碍事件总时间占总睡眠时间百分比呈正相关，与最低SaO2、平均最低SaO2呈负相关，而与年龄、身高、腰围、颈围及SCr、BUN、GFR无相关性（P〉0．05）。结论OSAHS患者UMA明显升高，而且与睡眠呼吸障碍程度密切相关，可以作为监测OSAHS患者早期肾损害的敏感指标。

Objective To observe the changes of urinary microalbumin （UMA）, and explore the relation between early impairment of renal function and level of UMA in patients with obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods OSAHS patients （n = 67） and healthy control subjects（n = 82）. Then body parameter, serum creatinine （SCr）, blood urea nitrogen （BUN）, glomerular filtration rate （GFR） and UMA were determined in both groups. Furthermore, linear correlation was performed between UMA and body parameter, SCr, BUN, GFR and sleep-breathing parameters of patients with OSAHS, respectively. Resuits UMA level was higher in OSAHS patients than that in control subjects （P 〈 0.01 ）. UMA level in OSAHS patients was correlated positively with body mass index （BMI）, apnea hypopnea index （AHI）, percentage of sleep time below 90% oxygen saturation （SaO2 〈 90%） and percentage of sleep time the total duration of apnea/hypopnea, respectively, and those were correlated negatively with the lowest SaO2 and the average lowest SaO2 respectively, but those had no Correlativity with age, stature, waistline, neckline, SCr, BUN and GFR （P 〉 0.05）. Conclusions UMA level increases in patients with OSAHS. The detection of microalbumin in urine is helpful in early diagnosis in OSAHS renal damage patients.